The Arizona State Board of Nursing on Friday reviewed the results of a three-day site visit in April and examined GCU's latest results on the RN licensing exam. Graduates had slipped below the state's standards for test passage two years in a row.

"It is very apparent from the site visit that the school has stepped up. ... I’m confident the hard work will continue and we’ll see even more improvement," board President Randy Quinn said.

The site visit noted a strong faculty and administrative commitment to addressing issues raised in the censure decree and said "significant progress is being made" in revising curriculum and in student performance on the nursing exam.

Reasons for censure

GCU's registered nursing program agreed to a decree of censure, which is a reprimand from the State Board of Nursing, in December, ending a 1½-year investigation by the board.

The nursing board censured GCU for five violations related to faculty rules and two tied to curriculum. Those included the college's failure to evaluate all faculty and several students failing to perform proper hand hygiene.

GCU officials have said previously that any classroom issues were one-time occurrences. In its most recent report to the board, GCU pledged to evaluate all faculty who have taught at least one year by the end of 2017.

State nursing board rules require programs to have pass rates of at least 80 percent for first-time test takers on the national nursing exam, known as NCLEX-RN. Nursing programs can receive a notice of deficiency from the board if they fall below that rate two years in a row or if a school falls below 75 percent for one year.

Grand Canyon's performance on the nursing exam has historically been above the state average.

Passage rates are reported on the nursing board's website each quarter with a running total for the year and a cumulative total at year's end. Year to date, GCU's pass rate was 74 percent; 313 graduates took the test for the first time with 232 passing and 81 failing.

The nursing board also is monitoring pass rates for those who graduated in April, which captures the semester when the college made changes to improve. The pass rate for April graduates who took the test was 87 percent, according to the board.

GCU implements changes

Lisa Smith, who was named GCU's nursing dean this year, told the nursing board that she has visited classrooms to see what is working well and what needs improvement. The program also added administrative support with a second associate dean, she said.

Grand Canyon officials declined comment to The Arizona Republic beyond what was said at Friday's board meeting.

In a previous interview, GCU officials said the decline in the exam-passage rates in 2015 and 2016 occurred when the nursing school rapidly increased enrollment to help address a nationwide shortage of nurses.

GCU's nursing school enrollment grew from 247 pre-licensure graduates in 2012 to 693 in 2015, before dropping to 510 last year.

Officials further attributed the decline to a tougher standard for passingthe national test beginning in 2013 and to significant curriculum changes made by GCU that took effect in fall 2014.

Pass rates for Grand Canyon University nursing students on the national nursing exam were 73 percent compared with 86 percent statewide in 2016. The previous year, GCU had a 79 percent passage rate while the statewide average was 87 percent.(Photo: Getty Images/iStockphoto)

Passage ratesat nursing schools statewide and nationally declined under the new licensing-test standards. But GCU's rates fell more sharply than Arizona's pass rate.

Changes to boost passage rates included hiring an NCLEX-RN success manager to help faculty and students. The program also offers individual and group coaching sessions for students. Students take "adaptive quizzes," which test their individual ability and take them through different levels of testing until they reach their goals.

The recent site visit by the nursing board noted that the university has increased the nursing program's budget by 13 percent for 2017.

The size of the program also is smaller with enrollment decreasing 28 percent, the report said.